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So to reiterate, tooth #10 was root canaled twice within 2 year period, it broke 2 years later and then abscessed. You had a dental implant placed which failed soon there after and then a second attempt at the graft and implant was done recently. You have had on going symptoms of an "infection" for a few years and have been prescribed antibiotics.
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Close. I do not currently have an implant in the site yet. The second attempt is planned this Spring. My dentist had intended to use a procedure called "ridge splitting" and put a thin implant in.
I actually did have a "collaplug" inserted when the failed implant was taken out. A day later, it "worked its way out" (there was a lot of inflammation in the area and it kind of... popped out of my gum).
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What that history generally indicates is that tooth #10 had been actively infected since at least 2009/2010 as a re-treatment of a second root canal procedure does not favorably alter the bacterial infection inside the dentin tubules. So between 2009 and 2014 the bacteria was spreading from the dentin tubules into the jaw bone.
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So are you saying that the is still infected? Is there any way to treat this bone infection? Are there ways for periodontists to spot it? Do I have to worry about it spreading to other teeth?
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You stated << The gum tissue above the site (ventral to me) was very thin, and I could kinda see the graft through it.>>
This finding indicates, just as you have suspected, a void in the bone which is referred to as bone loss and it is due to the long term presence of the infected tooth. The bony cartilage above the upper anterior teeth, #'s 7-10, is much thinner compared to other areas of the maxilla. Once the buccal plate or portion of this area of bone is lost, there is nothing more than thin gum tissue in it's place. Bone grafting material that is placed in an area where the buccal plate is gone is only being held in by lingual bone and gum tissue. This situation is not very stable as the purpose of the graft is to encourage your own bone cells to grow and integrate with the graft to form a more dense platform to place the dental implant into. However, bone cannot grow in or from gum tissue. This is likely the reason the first implant failed and to be honest it is heroic to attempt it again as the circumstances of the original bone loss has not changed.
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Does this mean that my only "safe" option is a bridge?
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It sounds like your dentist was wanting you to baby this area due to the delicate nature of the situation and the high probability of failure. However, in all probability hitting it with the water pik did not cause anything to fail but it may have just sped up the process. Taking the antibiotic can reduce the inflammation in that area but it cannot aid in the growth of new bone.
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I haven't taken an antibiotic quite yet. Interestingly, this morning it is definitely better. Swelling is down. The neighboring tooth, however (#11) feels kinda... weird. I noticed the inflammation was just as present and tender above it last night. I hope that doesn't mean that whatever this issue is is affecting a healthy tooth.
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You mentioned gut microbiome so I assume you are aware that antibiotics destroy the healthy intestinal flora. If you decide to take the meds, or even if you don't, please consider supplementing with a probiotic to replenish some good bacteria in your intestinal tract.
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I definitely would, but from what I've read, gut flora is permanently altered from antibiotics and the role of probiotics is questionable. I still take one during antibiotics (and often without) just in case, but I don't have a huge amount of confidence in them.
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Wish I could be more of a help. Your dental situation is not an easy one to restore with a dental implant as there is no fail proof way of rebuilding the buccal portion of the bone that was lost from the tooth infection.
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Thank you for trying to help me understand my situation better! If you were in my situation, would you get a bridge instead?
One thing I do want to add is that I did have a very similar situation happen with tooth #7. Root canaled around the same time, re-root-canaled at exactly the same time, broke at around the same time, got infected (AGAIN when I wasn't home), and had an implant placed. The implant was successful and I've had a crown on it for almost 2 months now. So far so good. I guess that gives me some hope. Obviously the degree of infection could have been different enough on #7 than on #10, but still...
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I assume you are wearing a removable partial?
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It is a plastic tray thing, not a full "flipper" but yes. I don't wear it too often, only when I go out in public (I freelance).